Individual
JOHN WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LSA
Contact information
Practice address
3905 MELCER DR STE 601, ROWLETT, TX 75088-4033
(214) 227-2457
(214) 764-0888
Mailing address
3905 MELCER DR STE 601, ROWLETT, TX 75088-4033
(214) 227-2457
(214) 764-0888
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
SA00753
TX
Other
Enumeration date
11/04/2013
Last updated
11/21/2023
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